Process improvements made at the agency level may enhance individual drug treatment outcomes (e.g., reduced criminal activity, increased employment) but these relationships are relatively untested. State information systems offer valuable yet underutilized methods of assessing provider performance and client outcomes. A collaborative investigation with Oregon's Addiction and Mental Health Division (the single state authority) permits an analysis of administrative data from Medicaid, corrections, and employment records to assess treatment outcomes. The current application extends the analysis of "Oregon and Washington NIATx Client Outcomes" currently funded by the Robert Wood Johnson Foundation through its Substance Abuse Policy Research Program (SAPRP) (award # 64146) which examines Medicaid, corrections and employment records of clients treated at two Oregon NIATx agencies. The SAPRP award examines client indicators pre/post NIATx implementation but the quasi-experimental pre/post design is weakened by the lack of comparison clinics (i.e., matched, non-NIATx agencies). Discussions with data managers in Oregon establish capacity for gathering client outcome data on matched non-NIATx agencies with similar characteristics (e.g., size, case-mix). In addition to strengthening the SAPRP project, success in linking databases and finding evidence of improved client outcomes for the NIATx clients will document the feasibility of these methods for an NIH application to conduct analysis of participants in NIATx200 (a randomized trial of 200 treatment centers learning NIATx process improvements - R01 DA020832). The SOAR project has one specific aim: to evaluate Medicaid utilization, criminal justice involvement and earned income for clients treated at a NIATx agency as compared to clients treated at a matched non-NIATx agency. Our hypothesis will be supported if clients treated at NIATx agencies will demonstrate greater improvement than non-NIATx clients on three outcomes: (a) reduced Medicaid costs for emergency and inpatient care, (b) reduced arrests and convictions, and (c) increased employment and income. PUBLIC HEALTH RELEVANCE: State information systems offer valuable yet underutilized methods of assessing provider performance and client outcomes. A collaborative investigation with Oregon's Addiction and Mental Health Division (the single state authority) permits an analysis of administrative data from Medicaid, corrections, and employment records to assess treatment outcomes. The current application extends the analysis of "Oregon and Washington NIATx Client Outcomes" currently funded by the Robert Wood Johnson Foundation through its Substance Abuse Policy Research Program (SAPRP) (award # 64146) which examines Medicaid, corrections and employment records of clients treated at two Oregon NIATx agencies.